In 2012, I wrote about the relationship between low testosterone and depression. Today, I want to update you on the latest research on the use of testosterone replacement therapy as a treatment for depression in men.
In February 2014, researchers from the Department of Neurology and Psychiatry at Saint Louis University published a review article that analyzed all the randomized, double-blind, placebo-controlled trials that have been conducted to date on low testosterone and depression. In the last decade, there has been a surge of new clinical trials studying the impact of testosterone therapy on mood, and the results of these studies have been inconsistent. The researchers’ goal was to better understand how well testosterone works for depression.
16 trials show testosterone is an effective treatment for depression in men
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They analyzed 16 trials with a total of 944 men and published their findings in the Annals of Clinical Psychiatry. The data showed a significant positive impact of testosterone on mood. They looked at the data from several different angles to gain a better understanding of testosterone’s precise influence.
- Age. The effects of testosterone on mood were most profound in men younger than 60 years of age. In older men, testosterone’s ability to boost mood was not as certain.
- Testosterone levels. Testosterone was significantly effective for boosting mood and treating depression in men with low baseline testosterone levels, but not in men whose testosterone levels were normal before the start of treatment.
- Depression severity. Testosterone worked best in men with either minor depression or dysthymia, a subtype of depression that is characterized by less severe but longer-lasting symptoms. Testosterone was still helpful in men with more severe depression, but the effect was not as strong.
Overall, the researchers concluded, testosterone is effective as the sole treatment for milder forms of depression in middle-aged men with low baseline testosterone levels. For men over 60 or those with more severe depression, testosterone may not be as effective, they said, calling for more research in these areas.
Most recent study on low testosterone and depression supports findings
Another clinical trial looking at testosterone’s effects on depressive symptoms was wrapping up around the same time the St. Louis researchers completed their study. The results of this six-month trial, published in the medical journal Aging Male, were consistent with previous studies in showing that testosterone replacement therapy effectively treats depression in men with low testosterone.
This study looked at 50 men with an average age of 57 who had low testosterone and were treated by urologists at the Kobe University Graduate School of Medicine in Japan. Thirty of the men were diagnosed with depression at the beginning of the study. For those men, depression symptoms significantly decreased by month 6, and only 11 of the 30 (36.7%) were still suffering from some depression after testosterone therapy.
Testosterone’s benefits go beyond depression
For all of the men, whether they had diagnosable depression at baseline or not, testosterone therapy significantly improved many aspects of health and well-being, including the following areas:
- Sleep problems
- Increased need for sleep/feeling tired
- Physical exhaustion/lacking vitality
- Decreased in muscular strength/feeling of weakness
- Depressive symptoms
- Total cholesterol
- Erectile function and libido
- Prostate symptoms
Choose bioidentical testosterone over conventional
As you can see, testosterone replacement therapy can make a huge difference in the lives of men with low testosterone. The physical and emotional benefits of testosterone therapy can be gained by using bioidentical testosterone, which is testosterone that has been synthesized to exactly match the testosterone produced inside the body. Many natural and integrative healthcare practitioners prefer to prescribe bioidentical forms of testosterone rather than the more commonly prescribed pharmaceutical testosterone gels and injectables, which do not exactly match the body’s natural testosterone and may be associated with more side effects and long-term risks.
Read more about symptoms of low testosterone and the use of bioidentical testosterone in my previous article on testosterone therapy for depression in men, found here. If you’ve tried testosterone therapy, please tell us about your experiences in the comments section below.
Originally published in 2015, this post has been updated.
 Ann Clin Psychiatry. 2014 Feb;26(1):19-32.